Retirees seek answers on change in benefits

[The blog is not responsible for accuracy of any of this information. See the information below on numbers to contact for information.]

All but a few chairs in the JSK conference room at the Beacon Journal were filled Wednesday by retirees attending an information session on the change in benefits.

Retirees will no longer be covered by United Health Care, a PPO (preferred provide organization) provider of secondary coverage, which allowed unlimited prescriptions at $2 co-pay for many with Medicare as the primary insurer.

The 329 retirees are now being asked to enroll in an Aetna (private fee for service) program which will handle both the Medicare and prescription program.

The Beacon Journal will pay the monthly premium.

A representative from Aetna outlined the program and answered questions. Also on hand were Aaron Burr, head of BJ Human Resources Department; Karen Jones, benefits coordinator and legal counsel Karen Lefton.

An answer to one question, explained that in reaching the $2,400 initial coverage limit the total would be based on actual drug costs. From that point until reaching the $3,850 level (called the coverage gap or donut hole) the retiree’s out of pocket costs and not the costs of the drugs would be used. Generic drugs during that period would still cost only the $5 co-pay.

There are no generic ($5 co-pay) drugs for diabetes or Alzheimer’s medications.

In answer to questions, Lefton explained that different contracts with different labor unions in different years could mean a difference in some benefits. She noted that letters were provided to some employees in years past promising certain benefits. But those promises had to be part of the contract or a legally-binding side-letter agreement and not just a notice given to employees. She said retirees should consult their contract at the time they retired to see what benefits were stipulated. Copies of these contracts and any side letters will be provided to retirees who request them, she said.

You can call benefits coordinator Karen Jones at 330-996-3183 for some information. For detailed information on the Aetna program it is probably best to call Aetna at 1-800-307-4830 or for the hearing impaired 1-800-628-3323.

The Aetna web site is at www.aetnamedicare.com You can read or download the Aetna formulary (list of drugs) for 2007 which lists drugs by brand name and generic name and states whether they are in Tier 1 or $5 co-pay for generic., Tier 2 ($20 co-pay) for preferred brand or Tier 3 ($40 co-pay for non-preferred drugs.

If you order drugs by mail, the co-pay is doubled but you get a 90-day supply rather than 30 days.